NPIMap

Organization Active NPI

Vibra Hospital of Central Dakotas LLC

  • Long Term Care Hospital
  • Mandan, ND
National Provider Identifier
1760822803
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
VIBRA HOSPITAL OF CENTRAL DAKOTAS LLC
Doing business as
Vibra Hospital of Central Dakotas
Practice address
1000 18TH St NW
Mandan, ND 58554-1612
Phone
(701) 667-2000
Fax
(701) 663-5944
NPI assigned
Jul 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Brad Eugene Hollinger
Title
President
Phone
(717) 591-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X ND Primary

Addresses

Primary practice location

1000 18TH St NW
Mandan, ND 58554-1612

Mailing address

PO Box 26657
Fresno, CA 93729-6657
Phone (559) 892-2500

Other names 1

  • Vibra Hospital of Central Dakotas Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130823000582 ND Part A Provider - Hospital 0244473270 Practice locations: Mandan, ND

Hospital certification: CCN 352005

Legal name
VIBRA HOSPITAL OF CENTRAL DAKOTAS LLC
Doing business as
VIBRA HOSPITAL OF CENTRAL DAKOTAS
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Sep 1, 1998
Last certification
Oct 18, 2007
Beds
41
Ownership / control type
Private (not for profit)
Most recent change of ownership
Sep 1, 2013 (1 total)
Organization structure
LLCProprietary
Incorporated
Apr 25, 2013 in DE
Enrollment address
1000 18TH St NW
Mandan, ND 58554-1612
Main/Primary Hospital Location
Hospital subgroups
Long-term

Hospital certification: CCN 350068

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SCCI - CENTRAL DAKOTAS
Certification status
Terminated Other: provider status change, Aug 31, 1998
Provider type (POS)
Hospital – Short-term
Participating since
Feb 6, 1998
Last certification
Feb 5, 1998
Beds
10
Ownership / control type
Private (for profit)
Facility address
1000 18TH Street NW
Mandan, ND 58554

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Vibra Hospital of Central Dakotas LLCCCN 352005 · All quality measures
Ownership
Non-profit
Certified
Sep 1, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Beds
41

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D0936014Vibra Hospital of Central Dakotas1000 18TH St NW, Mandan, ND 58554AccreditationMar 6, 2028

National Provider Directory

National Provider Directory

Locations

8081 Royal Ridge Pkwy
Ste 130
Irving, TX 75063
Phone (844) 870-6689

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kelly M Hollinger Individual Corporate OfficerVice President Mar 1, 2020
Vibra Management, LLC Organization, Mechanicsburg, PA LLC, For-profit Other Sep 1, 2013
Credit Suisse Ag Organization, New York, NY LLC, Financial institution, For-profit 5% Or Greater Security Interest Jul 22, 2020 100%
David E Hauck Individual Corporate OfficerTreasurer Oct 4, 2018
Trisha J Niemuth Individual Corporate OfficerVP/Sec Jan 1, 2022
Brad E Hollinger Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2013 77%
Corporate OfficerPresident Sep 1, 2013
Scott Schneider Individual W-2 Managing EmployeeCeo Dec 4, 2019

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1760822803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26657",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937296657",
            "telephone_number": "559-892-2500",
            "fax_number": "559-892-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 18TH ST NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585541612",
            "telephone_number": "701-667-2000",
            "fax_number": "701-663-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRA HOSPITAL OF CENTRAL DAKOTAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-03",
        "last_updated": "2023-10-10",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "HOLLINGER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-591-5700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vibra Hospital of Central Dakotas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vibra Hospital of Central Dakotas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mandan, ND

Sources for this page

Verify at the official NPI Registry.